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Home - Razor’s Edge – Fall 2010

The philosophy of the medical com­munity toward pain relief has changed in the last two decades, says Sorg, and this has played a role in the prescription drug problem. Healthcare providers have shifted from a reluctance to prescribe narcotic pain medications to the view that, in order for people to function, they have to be comfortable. Pain has become a quality issue in healthcare, with providers asking people about their pain levels and feeling freer — indeed, obligated — to treat them.

“When I was a nurse in the early ’70s, one of the most difficult problems we dealt with was pain relief,” Sorg says. “It was a recurrent problem. Post-op surgical patients, for example, had a hard time being comfortable at the levels of their prescriptions, frequently given by injection at four-hour intervals. Drugs had an early peak and decline. At the end of four hours, patients were begging for their shots.

“So now, healthcare providers are doing a better job treating pain. We have made improvements, but those improvements come with baggage.”

Unfortunately, there’s a certain risk that a minority of people will get addicted when narcotics are prescribed, Sorg says.

“People’s vulnerability to addiction varies greatly: Some people are more physically and behaviorally susceptible to addiction,” Sorg says. “And the problem with narcotics is that people’s tolerance may change over time. For example, some people who continue to take a drug at one dose may eventually need a higher dose to do the same job. Increased consumption carries increased risk, particularly if it’s not medically supervised, including potentially fatal respiratory depression.”

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